Sunday, April 3, 2016

Access to free antiretroviral
therapy (ART) in Sub-Saharan Africa has been steadily increasing over the past
decade. However, the success of large-scale ART programmes depends on timely
diagnosis and early initiation of HIV care.

This study characterizes late
presenters to HIV care in Santiago (Cape Verde) between 2004 and 2011, and
identifies factors associated with late presentation for care. We defined late
presentation as persons presenting to HIV care with a CD4 count below 350
cells/mm³. An unmatched case-control study was conducted using
socio-demographic and behavioural data of 368 individuals (191 cases and 177
controls) collected through an interviewer-administered questionnaire,
comparing HIV patients late and early presented to care. Logistic regression
was performed to estimate odds ratio and 95% confidence intervals.

Results show
that 51.9% were late presenters for HIV. No differences were found in gender
distribution, marital status, or access to health services between cases and
controls. Participants who undertook an HIV test by doctor indication were more
likely to present late compared with those who tested for HIV by their own
initiative. Also, individuals taking less time to initiate ART are more likely
to present late.

This study highlights the need to better understand reasons
for late presentation to HIV care in Cape Verde. People in older age groups
should be targeted in future approaches focused on late presenters to HIV care.